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A patient hadacuteonsetoferythematouspapules that coalesced into plaquesin an inverse photodistribution associated with malaise, fever, and nonproductive cough. Low-gradedisseminated intravascularcoagulation (DIe) quickly developed. This article highlights the ability of atypical measles to mimic several life-threatening conditions, extends our clinical understanding of this potentiallyseriousdisorder, and emphasizes the utilityofrapid, direct immunofluorescence techniques1,2 in diagnosis.

The yellow nail syndrome is characterized by yellow, slow-growing nails in association with lymphedema, idiopathic pleural effusions, chronic bronchiectasis, and chronic sinusitis. We report two patients with yellow nail syndrome in whom spontaneous clearing of the nail changes occurred without resolution of the respiratory involvement. This observation suggests that nail changes may not result from the systemic manifestations. We also report for the first time the histopathologic findings of the nail matrix and bed, which demonstrate dense, fibrous tissue replacing subungual stroma with numerous ectatic, endothelium-lined vessels that are similar to that in the pleura in yellow nail syndrome. We hypothesize that primary stromal sclerosis may lead to lymphatic obstruction, thus explaining the clinical manifestations.

In a patient receiving intralesional bacille Calmette-Guérin vaccine injections for recurrent cutaneous metastases of malignant melanoma of the right leg, a striking eruption developed on that limb only. The eruption consisted of multiple 1 to 2 mm, reddish brown, flat-topped papules, with confluence into plaques. Histopathologic examination showed multiple tuberculoid granulomas within the papillary and reticular dermis; special stains and cultures were negative for mycobacteria.